Battling the Heroin Epidemic: Real Leadership, Concrete Action

https://www.youtube.com/watch?v=gO00-pgU6hI&feature=youtu.be

The heroin epidemic continues to explode throughout Ohio, impacting small towns and large cities alike. It has caused thousands of overdose deaths and empty lives, fueled property crimes and home invasions, and overwhelmed the criminal justice system. The financial costs for the state are now in the billions of dollars.

Recent bipartisan legislation has begun to implement solutions, but Ohio’s statewide officials have yet to take on the heroin crisis in an aggressive or comprehensive way. Indeed, they have made a number of decisions taking us in the wrong direction. For example, even as statewide leaders claim the answers must come from “grassroots,” local communities, the state deprived local governments of critical resources to tackle the problem at the very time the crisis exploded.

Attorney General DeWine’s Response: “Nothing More than a Pep Talk” 

Ohio’s heroin epidemic is not new. Deaths associated with heroin use have risen dramatically since 2010, a predictable consequence of the crackdown on “pill mills” without corresponding increase in available drug treatment. Yet the Attorney General’s office did not even begin analyzing heroin data until October 2013, years into the crisis.[1] Since finally declaring an epidemic, DeWine has failed to offer a serious response, instead holding a series of town hall meetings and forming a poorly defined “$1 million heroin unit.”  As one newspaper stated about the town hall meetings, “it’s disparaging when an elected official travels around the state giving what amounts to nothing more than a pep talk.” (Coshocton Tribune, 2/1).  The paper added: “[DeWine’s] office would not say what this new unit, which cost $1 million to form, has accomplished since its inception in November.”

While DeWine and Ohio have dithered, other states are acting.  For example, Kentucky officials have been well ahead in addressing this crisis. The Northern Kentucky Heroin Impact and Response Workgroup was formed in 2012 and issued a comprehensive report with recommendations in Fall 2013 — the same time that DeWine’s office was just beginning to collect data on the issue.[2]At the same time DeWine began giving pep talks and touting his $1 million unit, Kentucky’s Attorney General dedicated $32 million for treatment efforts alone.  David Pepper’s plan will put Ohio where other states are:

The Pepper Plan: A Comprehensive Approach to Take on Heroin Addiction

1.   Treat the Heroin Epidemic as a Public Health Crisis

That’s what it is and it must be approached that way. A $1 million heroin “unit” is wholly insufficient to addressing the scale of this problem. As occurred in Northern Kentucky, Pepper will bring public health officials from across the state into a public conversation with law enforcement, and form a multi-agency Heroin Task Force to track in real time the crisis at the local and regional level and propose and monitor the impact of solutions.

2.   Drying Up Demand
  • Evidence-Based Prevention – The most important decision in addressing the heroin crisis is the individual decision of each and every Ohioan to be responsible and avoid starting down the path to addiction. Smart investments in prevention are the best investment the state can make. While there are many well-intentioned prevention programs, good intentions won’t solve this crisis. There is clear evidence in place that some programs work effectively and are a good investment, and others are not.  Ohio can’t afford not to know the difference:
    • Best practices: Pepper will work with prevention experts at the state and local level to inventory prevention and education initiatives to ensure that high quality and evidence-based best practices are in place across the state—particularly with the state’s young people.  If there are major gaps in prevention services, Pepper will work with the legislature to find funding to fill those gaps. Pepper will also share with local governments and agencies what the evidence shows are the best prevention efforts, so that every dollar invested in prevention is invested effectively.
    • Schools: Thanks to cuts to local government funds and from the Attorney General’s office, Ohio’s schools have far fewer school resource officers than they did a few years ago—and these officers can play critical roles in prevention for young Ohioans. Pepper will push for ways to restore these critical resources, along with other best practices, back in our schools at a time where they’re so badly needed.
  • Dramatically Increasing Quality Treatment: While prevention is important, it is not enough—Ohio must greatly increase the capacity of high-quality treatment, and the necessary continuum of treatment, in Ohio’s communities and regions. As the Cleveland Plain Dealer recently wrote: “the lack of beds available for detox and treatment remains a statewide embarrassment.” (Plain Dealer Editorial, 2/18/14). Cash-strapped rural counties simply do not have the funds to handle the problem; even wealthier counties have far too little treatment (Plain Dealer, 4/1/14 — noting that Medina County doesn’t have one residential treatment program)
    • Treatment Inventory: As Attorney General, Pepper will work with public health experts at the state and local levels to inventory the treatment needs and capacity in counties and regions throughout the state, identify the gaps and waiting lists
    • Adding Capacity: Pepper will work with the legislature to bring meaningful treatment dollars back to local communities to increase access to high quality, evidence-based treatment. As the Plain Dealer wrote, “without a fiscal commitment to recovery, the war will never be won.” (PD, 2/8/14)
    • Evidenced-Based Treatment: As with prevention, all treatment is not equal.  Pepper will work with treatment experts to ensure that evidence-based best treatment practices are being adopted across the state, and that a treatment continuum is available to meet the various stages of recovery.  For example, one recent study showed that only half of Ohio addiction facilities offer medications proven to battle heroin addiction, while 82% of West Virginia facilities do so. Treatment grants should flow to those programs the evidence shows make the biggest difference.
    • Training for Healthcare Professionals: A key step in this process includes providing additional training to physicians, nurses and other health professionals on the front lines about addiction and medication-assisted treatment.  Too few are up to speed on the best practices and protocols required to tackle the addiction epidemic.
  • Targeting the Oversupply of Opioids—Recovering Funds to Address the Crisis: Much of the demand for heroin results from the oversupply and over-marketing of powerful prescription drugs. Sadly, there is significant evidence that drug companies engaged in marketing campaigns that overstated the benefits and understated the risks of powerful opioids.  Many Ohioans who have been targeted by these efforts, will spend years on opioids, and many of them are moving to heroin because it is far less expensive. As Attorney General, Pepper will pursue litigation, when appropriate, against companies that have engaged in these practices. Such suits can recover funds to provide funding for addiction treatment, and can require drug companies to honestly disclose the real risks of opioids. (Kentucky’s Attorney General recently secured $32 million for treatment through pharmaceutical litigation).
  • Step Up Treatment in Criminal Justice System: Addicts are often most responsive to treatment at the moment they enter the criminal justice system—and if an addiction is unaddressed during a jail term, the underlying problem simply continues unabated.  Pepper will work with the legislature and local governments to enhance the ability of courts, sheriffs, prosecutors and defense lawyers to intervene with addicts at that key moment, and provide treatment through the criminal justice process—funded by Medicaid expansion whenever possible.  This can include providing treatment/intervention in lieu of prosecution when appropriate, or as conditions of release or monitoring.  It also includes adding drug court options in counties that do not have them today, and ensuring that CBCF facilities (Community Based Correctional Facilities) and other facilities are capable of handling the new inflow of heroin addicts.  Finally, given the breadth of the problem, Pepper will work with the legislature to remove some statutory obstacles that eliminate the option for treatment for many low-level offenders who badly need treatment, only continuing the cycle of addiction and criminal activity.
3.   Saving Lives

If administered in a timely fashion, the prescription drug Naloxone (Narcan) can prevent overdose deaths.  Communities in the country that have distributed Narcan broadly have seen overdose deaths drop quickly.  Ohio must get this life-saving drug in the hands of first responders and health care providers as quickly as possible.  A bill just passed that allows this to happen.  Under Pepper, the AG’s office will do all it can – from law enforcement training to assisting in implementation – to ensure this tool is used to its greatest effect.

4.   Cracking Down on Supply/Dealing

While those with addictions need treatment, those selling heroin and causing the death of so many need to know there will be real and immediate accountability here in Ohio. Working with local law enforcement, Pepper will take a number of steps to make this happen in very corner of the state.

  • Cracking Down on Dealers: For every overdose death in Ohio, there is a dealer who sold that drug…and who caused that death.  Pepper will provide special prosecutor support to County prosecutors, and special training for law enforcement, seeking the most severe sentences on drug pushers whose sales are directly linked to overdose deaths. Pepper will also seek sentencing enhancements for those who are selling drug combinations that are known to be particularly lethal, as well as those who are found to be repeat heroin sellers.
  • Real-Time Data Analysis: With today’s technology, the Attorney General’s slow response to the heroin crisis—tabulating heroin data years after the fact and then declaring a crisis in late 2013—is unacceptable, and will not solve the problem going forward. Pepper will modernize the office so it can more effectively tackle the supply/law enforcement side of this problem in real-time. Working with local law enforcement, other state agencies and substance abuse experts, Pepper will upgrade and modernize the ability of law enforcement and health officials to map and track heroin use, overdoses, trafficking and results of intervention efforts—and use that data to identify real-time data on hotspots of heroin trade, patterns, overdoses, and other telltale signs, allowing state and local officials to deploy resources to crack down as problems flare up, not years after.
  • Intelligence: Pepper will work with local jurisdictions to bolster the intelligence and surveillance needed to track and clamp down on heroin dealer networks throughout Ohio.
  • Cross-state Cooperation: Pepper will work with Attorneys General and law enforcement in neighboring states and federal authorities to devise new, cooperative strategies to control the flow of heroin around the region. This will help control access to heroin in the state.
5.   Support and Training for Local Law Enforcement

Local law enforcement and first responders represent the front line in the fight against heroin on our streets. And they need the best training possible to do so. Whether it is responding to overdoses to save lives, or processing an overdose crime scene so evidence can be preserved to tie the death back to a dealer, cutting-edge training is the key to getting the job done. Instead of slashing general fund support for training, and depriving local officials of promised casino dollars intended for training, Pepper will re-prioritize training as a key step in battling this epidemic.

Coshocton Tribune Editorial – Talk is Cheap: Money Needed to Fight Drugs

Elected officials from around the state are recognizing David’s leadership in proposing a comprehensive solution to battle Ohio’s heroin crisis. Watch the videos below to see what these leaders have to say:

Paul Worley, Adams County Commissioner:

Paul Worley is a first-term Adams County Commissioner. Worley ran for office in 2012 after leaving the military, where he served as an Army Infantry Captain and served two tours in Iraq and one tour in Afghanistan. Over the course of his career with the military, Worley was awarded a Bronze Star Medal with Valor, two Bronze Star Medals, the Defense Meritorious Service Medal, and the Army Commendation Medal, among others.

PG Sittenfeld, Cincinnati City Councilman:

PG Sittenfeld is in his second term as a member of the Cincinnati City Council. Throughout his time in office, Sittenfeld has helped to transform schools into community centers in the evenings, offering health, educational, cultural and recreational program opportunities to citizens of Cincinnati communities. These programs have received numerous national awards and national recognition for their impact in fighting poverty, reinvigorating neighborhoods and encouraging student achievement.

Adam Brannon, Mayor of Bellefontaine:

Adam Brannon is in his second term as Mayor of Bellefontaine, Ohio. Brannon graduated from the University of Findlay with a major in Political Science and a minor in Public Administration. While in college, Brannon served as a Legislative Intern for the National Volunteer Fire Council in Washington, D.C. As Mayor of Bellefontaine, Brannon oversees 11 different departments in Public Safety, Public Works and Public Finance.

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[1] Ohio Attorney General Mike DeWine Statement, 11/18/13

[2] Cincinnati Enquirer, 11/10/2013